Risk Assessment: An enabler or barrier. Aideen Gallagher B.Sc. OT., MOHS, MPH, PG Dip

Transcription

1 Risk Assessment: An enabler or barrier Aideen Gallagher B.Sc. OT., MOHS, MPH, PG Dip

2 Presentation outline What is risk? How do we address the management of risk? Can we enhance the way we use it?

3 Role of Manual Handling Advisor Maintain safety of person and carer Reduce incidence of musculoskeletal injury Risk = injury

4 What is Risk? Chance or possibility of danger, loss, injury or other adverse consequences (Oxford University Press, 2003) Level of dangerousness (Duncan, 2008) The likelihood of an event happening with potentially harmful or beneficial outcomes for self or others (Carson, 2010)

5 Value of risk mental health literature Dignity of risk Opportunity to make choices Responsibility versus compliance and conformity Opportunity for learning and growth Therapeutic risk taking positive risk taking (Lawson, 2010) (Stickley & Felton, 2006)

6 Risk Continuum mental health literature Non-therapeutic Therapeutic Harmful Negative Opportunity Positive

7 Creativity and Risk Rehabilitation versus management Mental health and manual handling deviate Darragh, Campo & Olson (2009) Creativity problem solving To be creative is to take a risk Divergent thinking Csikszentmihalyi (1997)

8 What is risk assessment/management? Determine which hazardous manual handling tasks in your workplace pose a risk of musculoskeletal injury Victorian Work Cover Authority (1985) Preventing/minimising the probability of unwanted and negative consequences (Eriksson & Hummelvoll, 2008)

9 Risk Management Risk Identification Statement of the situation/identification of the problem Risk Assessment Likelihood and Severity of event Risk Control How can risk be minimised, limiting residual risk

10 When do we use risk assessment? When danger is present/promote safety Efficiency? Opportunity to test out/verify options? When no rules to guide Who are rules for/not for? Herd mentality? Stifle creativity no working it out (Fawcett & Rhynas, 2014). How are rules communicated? Experience = competence To many people "experience" means "making the same mistakes with increasing confidence over an impressive number of years" (O Donnell, 1997)

11 When do we use it? Covering ones back Accountability and blame Avoid claims of negligence Lack of meaningful engagement Missed opportunity to engage in creative thinking Static versus dynamic Academic versus practical Narrative problem solving what would this look like/opportunities? (Divergent thinking) what are the risks to be aware of (Convergent thinking)

12 Creativity and Risk Neil Perkin, 2010

13 Implementing risk assessment Eases anxiety Promotes opportunities that professionalism and responsibility offer professionals (Carson, 2010) Enable sound decision making Give confidence in fully justifying decisions (Lawson, 2010) Job fulfilment

14 Litigation: No law of risk or risk taking Legal concepts: Negligence or Recklessness (Carson, 2010) Risk assessment minimises chances of negligence Determines harmful from unharmful The Balance

15 Risk Assessment and professional Practice How many of us make decisions based on what is always done as oppose to really thinking about it? How many of use look for rules as oppose to logically using our clinical reasoning and thinking it out?

16 Conclusion Risk not just about injury Risk offers opportunity for creative problem solving Divergent thinking allows problem solving to take place Risk assessment = framework for convergent thinking after creative solutions explored Risk assessment safety net Avoids over reliance on rules and danger

17 References Carson, D (2010). Risking Legal Repercussions. In: Kemshall, H., Pritchard, J. Good Practice in Risk Assessment and Risk Management. Jessica Kingsley Publishers, London and Philadelphia Duncan EAS (2008). Forensic Occupational Therapy. In: J Creek, L Lougher, eds. Occupational Therapy and mental health. 4 th ed. Edinburugh: Churchill Livingstone, Eriksson. B.G. & Hummelvoll, J. K. (2008). People with mental disabilities negotiating life in the risk society: a theoretical approach. Journal of Psychiatric and Mental Health Nursing, 15, Lawson, J (2010) A framework of risk assessment and management for older people. In: Kemshall, H., Pritchard, J. Good Practice in Risk Assessment and Risk Management. Jessica Kingsley Publishers, London and Philadelphia Oxford University Press (2003). Oxford English Reference Dictionary. Snowden, P. (1997). Practical aspects of clinical risk assessment and management. British Journal of Psychiatry, 170 (suppl. 32), Stickley, T. & Felton, A. (2006). Promoting recovery through therapeutic risk taking. Mental Health Practice, Vol 9 (8), Victorian Work Cover Authority (1985) Code of Practice for Manual Handling Darragh, Campso and Olson (2009). Therapy practice within a minimal lift environment: Perceptions of therapy staff. Work 33 (2009) O Donnell M. A sceptic s medical dictionary. Oxford: Blackwell BMJ books, 1997 Csikszentmihalyi M (1997) Creativity: flow and the psychology of discovery and invention. New York: HarperCollins. Fawcett TJ, Rhynas, SJ. (2014). Re-finding the 'human side' of human factors in nursing: Helping student nurses to combine person-centred care with the rigours of patient safety. Nurse Educ Today Jan 25.